Borderline Personality Disorder (BPD) – Criteria & More

Borderline Personality Disorder (BPD)

What is BPD?
BPD is caused by an inability to regulate your emotions.

What are the symptoms of BPD?
In order to receive a diagnosis of BPD, you must exhibit 5 of the following 9 symptoms:

• Frantic efforts to avoid real or imagined abandonment.
• A pattern of unstable and intense personal relationships.
• Identity disturbance
• Impulsivity in at least two areas that are potentially self damaging
• Recurrent suicidal behavior, gestures, threats or self-mutilating behavior.
• Affective instability due to a marked reactivity of mood.
• Chronic feelings of emptiness.
• Inappropriate, intense anger.
• Transient, stress related paranoid ideation or severe dissociative symptoms.

Why is it called “Borderline”?
It was believed that it was on the “borderline” between psychosis and neurosis.  It’s now being considered being renamed “Emotional Dysregulation Disorder”.

Risk Factors:
Being hypersensitive and growing up in an invalidating environment can lead to having BPD.

What can I do to help?
People with BPD need their emotions to be validated.

What is the best treatment for BPD?
One of the best treatments is Dialectical Behavioral Therapy or DBT.

Can medications cure BPD?
There is no cure for BPD.  The symptoms can be treated with medications.

What other conditions can people with BPD have?
People usually have co-morbid conditions along with BPD.  The most common are:  depression, anxiety, PTSD.

When does BPD strike people?
BPD usually strikes in adolescence.

What obstacles do people with BPD face?
People with Borderline Personality Disorder have been seen as “difficult”, “manipulative” and “attention-seeking”.

People are often undiagnosed or misdiagnosed for sometimes years before getting the correct diagnosis.  Many of them are misdiagnosed as having Bi-Polar Disorder.

Can adolescents get BPD?
People are not usually diagnosed with BPD until they are 18.  They can be misdiagnosed as having “Oppositional Defiant Disorder” or “Conduct Disorder”.  If they have had symptoms for at least one year, they may be considered as having BPD traits.

Are the brains of people with BPD different?
Yes.  We can see in the brains of people with BPD that the part of the brain that controls emotions is highly active compared to people without the disorder.  And the part that brings their emotions back to baseline is much less active than in others.  It takes people with BPD a lot longer to calm down that people without it.  Telling someone with BPD to “just calm down” is actually highly counterproductive.  What they need is to be validated with how they are feeling.

What can we do about BPD?
We need to raise awareness and reduce the stigma of BPD, especially in adolescents.  Many people needlessly suffer for years before getting the correct diagnosis, if they even get it at all.  Many Borderlines, up to 75%, attempt suicide, some many times.   About 10% of them will actually succeed.  There are different types of Borderlines.  Some are the Quiet Borderline, who don’t “act out” as much as the typical Borderlines.  Because they turn their anger inwards into depression, they can be more at risk.

People with BPD can be very hard to live with, with all of their rapidly changing strong emotions.  If it’s hard for you to deal with, just imagine what it’s like for them to live with it every single day of their lives.

Marsha Linehan, the founder of DBT,  likens it to an “emotional third-degree burn victim”.  It can feel like they’re emotionally bleeding to death.

How many people have BPD?
It’s estimated that up to 6% of the population has BPD, more than schizophrenia and Bipolar Disorder combined.  Yet there is much less awareness of BPD.